Medical device handles and related methods of use

ABSTRACT

A device may include a sheath including a lumen, a distal end, and a proximal end. The device may further include an end-effector unit and an elongate member connected to the end-effector unit. The end-effector unit and the sheath may be movable relative to each other to achieve a first state of the end-effector unit and a second state of the end-effector unit. Moreover, the medical device may include a handle having a first handle portion connected to the proximal end of the sheath, a second handle portion connected to the proximal end of the elongate member, and a compliant member longitudinally aligned with the sheath between the first handle portion and the second handle portion. The first and second handle portions may be configured such that relative movement of the first and second handle portions causes the end-effector to move between the first and second states.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a Continuation Application of U.S. patentapplication Ser. No. 14/642,479, filed Mar. 9, 2015, which is acontinuation of U.S. patent application Ser. No. 13/558,505, filed Jul.26, 2012 (now U.S. Pat. No. 9,005,196) which claims the benefits ofpriority under 35 U.S.C. §§119-120 to U.S. Provisional Application No.61/524,073, filed on Aug. 16, 2011, all of which are incorporated hereinby reference in their entireties.

FIELD OF THE INVENTION

This disclosure relates to handle assemblies for medical devices andrelated methods of use. More particularly, embodiments of the disclosurerelate to improved handles for actuating and positioning medicalimplements by a single hand of an operator.

BACKGROUND OF THE INVENTION

Minimally invasive surgical devices, such as endoscopes, laparoscopes,and retrieval devices can provide access to remote surgical sites withina human body through body openings, cavities, or tracts. Such surgicaldevices may include elongate portions that are maneuverable in theopenings and that allow an operator to simultaneously view and operateat the remote site. In the field of urology, medical retrieval devices,such as collapsible baskets, graspers and the like, are used to retrievevarious foreign or biological materials, such as kidney stones, urinarycalculi, and choleliths, from within a body. In certain urologicalprocedures, the retrieval device is used to immobilize kidney stonesrelative to a laser fiber. Lithotripsy then fragments the stones forretrieval and removal by the retrieval device.

Medical retrieval devices typically include a sheath and anobject-engaging unit, such as a basket, that is moveable relative to thesheath from a collapsed state within the sheath to another state inwhich the unit extends past the distal end of the sheath. The sheathtypically extends from a handle, located at the proximal end of thesheath to the object-engaging unit which is located at the distal end ofthe sheath. As such, the term “proximal end” refers to the end away fromthe patient and the term “distal end” refers to the end near the patientand that goes into the patient. The handle often includes a mechanismfor actuating the object-engaging unit in order to move theobject-engaging unit between the collapsed and extended, expandedstates.

During a urological procedure, a physician moves the distal end of themedical retrieval device in relation to the distal end of an insertiondevice, e.g., a ureteroscope. This may be accomplished by gripping thesheath just proximal to the point where the retriever sheath isintroduced into a channel within the ureteroscope. As the physicianoperates the ureteroscope and positions the sheath of the retrievaldevice, an assistant is required to actuate the handle at thephysician's direction to retrieve foreign material.

In procedures that utilize a laser fiber and a retrieval device, thephysician must carefully hold and reposition the two items relative toeach other and to the ureteroscope. Currently, an operator mustmanipulate and actuate each device independently or with the assistanceof another operator. Such procedures can become time consuming andcumbersome.

In light of the foregoing, there is a need for an improved handle for amedical retrieval device that allows for the device to be introduced,positioned, and actuated by a single hand of an operator.

SUMMARY OF THE INVENTION

Embodiments of the disclosure are directed to improved handles formedical devices, and related methods of use that obviate one or more ofthe limitations of the prior art medical device handles.

One embodiment of the disclosure is directed to a medical device. Thedevice may include a sheath including a lumen, a distal end, and aproximal end. The device may further include an end-effector unit and anelongate member connected to the end-effector unit and extendingproximally from the end-effector unit within the lumen of the sheath.The end-effector unit and the sheath may be movable relative to eachother to achieve a first state of the end-effector unit and a secondstate of the end-effector unit. Moreover, the medical device may includea handle having a first handle portion connected to the proximal end ofthe sheath, a second handle portion connected to the proximal end of theelongate member, and a compliant member longitudinally aligned with thesheath between the first handle portion and the second handle portion tohold the first handle portion and the second handle portion in a spacedapart position. The first and second handle portions may be configuredsuch that relative movement of the first handle portion towards thesecond handle portion causes the end-effector to move between the firststate and the second state.

In various embodiments, the medical device may include one or more ofthe following additional features: the first handle portion may bedistal of the second handle portion; the second handle portion may bedistal of the first handle portion; the handle may include a lockingmechanism to secure the first and second handle portions after the firsthandle portion is moved toward the second handle portion; theend-effector unit may be a self-expandable basket having a plurality oflegs; in the first state, the end effector unit may be within the lumenand in the second state the end-effector unit may extend from the distalend of the sheath; in the first state, the end-effector unit may extendfrom the distal end of the sheath and in the second state theend-effector unit may be within the lumen; the basket may be collapsedwhen the end-effector unit is in the first state and expanded when theend-effector unit is in the second state; the basket may be collapsedwhen the end-effector unit is in the second state and expanded when theend-effector unit is in the first state; a distal end of the elongatemember may be connected to a proximal end of the end-effector unit; thecompliant member may define a lumen and may be made of a material thatcompresses under force and returns to its original state once the forceis removed; the elongate member may be at least one of a tube, a shaft,a wire, a coil, or a cable connected to a proximal end of theend-effector unit; the handle may include an electrical connector fordelivering electrical current to the end-effector unit; one of the firsthandle portion and the second handle portion may include geometricfeatures for receiving one or more fingers of an operator and themedical device may include two or more distinct end-effector units, eachseparately actuatable by the handle.

According to another embodiment, a medical device may include a sheathhaving a lumen, a distal end, and a proximal end may be provided. Themedical device may further include a handle having a first handleportion connected to the proximal end of the sheath, a second handleportion including a hole, and a tube disposed between the first andsecond handle portions. The tube may include a distal end, a proximalend, and a lumen extending in between. The distal end of the tube may beslidably disposed within the sheath, and the proximal end of the tubemay be connected to the second handle portion and be in communicationwith the hole in the second handle portion. The handle may furtherinclude a compliant member positioned around the tube between the firsthandle portion and the second handle portion to keep them in a spacedapart position. The lumen of the tube may be configured to receive adevice, and wherein moving the second handle portion towards the firsthandle portion may cause the device to be pushed towards the distal endof the sheath.

In various embodiments, the medical device may include one or more ofthe following additional features: a portion of the medical device mayfurther include an engaging member that selectively protrudes from asurface of a portion of the medical device; the engaging member mayprotrude when the second handle portion is pushed towards the firsthandle portion and may retract when the first and second handle portionreturns to the spaced apart position.

A further aspect of the present disclosure provides a method foroperating a medical device to perform an operation in a body. The methodmay include the step of advancing a medical device to a position withina body. The medical device may include a sheath including a lumen, adistal end, and a proximal end. The device may further include anend-effector unit and an elongate member connected to the end-effectorunit and extending proximally from the end-effector unit within thelumen of the sheath. The end-effector unit and the sheath may be movablerelative to each other to achieve a first state of the end-effector unitwhen the end-effector unit is within the lumen and a second state of theend-effector unit when the end-effector unit extends from the distal endof the sheath. The device may further include a handle having a firsthandle portion connected to the proximal end of at least one of thesheath, a second handle portion connected to the proximal end of theelongate member, and a compliant member longitudinally positionedbetween the first handle portion and the second handle portion to keepthe handle portions in a spaced apart position. The method may furtherinclude the steps of grasping the handle with a hand of an operator in aposition to push one of the first and second handle portions towards theother, and pushing a handle portion towards the other to selectivelyactuate the end-effector unit between the first state and the secondstate.

In various embodiments, the method may further include the additionalfeatures of locking the first and second handle portions to preventrelative movement between the two handle portions.

Additional objects and advantages of the disclosure will be set forth inpart in the description which follows, and in part will be obvious fromthe description, or may be learned by practice of the disclosure. Theobjects and advantages of the disclosure will be realized and attainedby means of the elements and combinations particularly pointed out inthe appended claims.

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and explanatory onlyand are not restrictive of the disclosure, as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the disclosure andtogether with the description, serve to explain the principles of theinvention.

FIG. 1 is a schematic view of a medical device with a collapsedend-effector and a handle in a spaced apart position according to anembodiment of the present disclosure.

FIG. 2 illustrates the medical device of FIG. 1 in an actuated stateaccording to one embodiment of the present disclosure.

FIG. 3 illustrates a medical device with finger grooves in a handleaccording to an embodiment of the present disclosure.

FIG. 4 is a schematic view of a medical device with a handle accordingto another embodiment of the present disclosure.

FIG. 5 illustrates the medical device of FIG. 4 in an actuated state.

FIG. 6 is an exploded view of the medical device of FIG. 4.

FIG. 7A is a schematic view of a handle of the medical device of FIG. 1,illustrating a locking mechanism in the open position according to oneembodiment of the present disclosure.

FIG. 7B is a schematic view of the handle of FIG. 7A illustrating thelocking mechanism in a closed position.

FIG. 8A is a schematic view of a handle of the medical device of FIG. 1,illustrating a locking mechanism in the open, unlocked positionaccording to another embodiment of the present disclosure.

FIG. 8B is a schematic view of the handle of FIG. 8A illustrating thelocking mechanism in a closed, locked position.

FIG. 8C is a side view of the handle of FIG. 8B illustrating the lockingmechanism in a closed, locked position.

FIGS. 9A-9C is a schematic view of a medical device according to anotherembodiment of the present disclosure.

FIG. 10A is a schematic view of a medical device housing multiple tools.

FIG. 10B illustrates the medical device of FIG. 10A in an actuatedstate.

DESCRIPTION OF THE EMBODIMENTS

Reference will now be made in detail to embodiments of the disclosure,examples of which are illustrated in the accompanying drawings. Whereverpossible, the same reference numbers will be used throughout thedrawings to refer to the same or like parts.

Referring to FIGS. 1 and 2, one embodiment of a medical device 100includes a handle 102, a sheath 104, and an end-effector unit 106 allextending along a longitudinal axis 10. The sheath 104 may be flexible,and it may include one or more internal lumens for receiving one or moreend-effectors, such as the end-effector unit 106, imaging devices, etc.As will be described in more detail below, the end-effector unit 106 andthe sheath 104 are movable relative to each other in order to achieve afirst collapsed state of the end-effector unit 106 (seen in FIG. 1) inwhich the end effector unit 106 is collapsed within the lumen of thedistal end of the sheath 104 and a second state in which theend-effector unit 106 extends from the distal end of the sheath 104 andexpands to an operable or actuated state (seen in FIG. 2).

The end-effector unit 106 may include a basket, a grasper, pincers,snares, or any other retrieval or grasping device. In some embodiments,the end effector unit 106 may be self-expandable. Moreover, theend-effector unit 106 may include a device for performing a therapeuticor diagnostic operation in a body such as a urological, endoscopic, orother such operation. For example, the end-effector unit 106 may includean ablation probe, cautery, or a lithotriptor without departing from thescope of the disclosure. In the figures presented here, as an example,the end-effector unit 106 is illustrated as a basket, such as aself-expandable percutaneous nephrolithotomy (PCNL) basket havingseveral legs. The basket may be made of any memory metal such asnitinol.

The handle 102 further includes a first handle portion and a secondhandle portion such as an upper handle portion 108 and a lower handleportion 110, separated by a compliant member 112 longitudinally alignedalong the longitudinal axis 10. Here, the first handle portion isillustrated as the upper handle portion 108 (at the distal end of thehandle) while the second handle portion is illustrated as the lowerhandle portion 110 (at the proximal end of the handle). It will beunderstood, however, that the handle portions may be interchangeablyillustrated in other embodiments. For example, the first handle portionmay be the lower handle portion 110 and the second handle portion may bethe upper handle portion 108 in other embodiments.

The compliant member 112 may be configured as a tube or sleeve defininga lumen through which an elongate member 114 or the sheath 104 mayextend. Further, this compliant member 112 may be a spring element suchas a helical spring, an elastic sleeve, or any other such material thatcompresses under force and returns to its original state once the forceis removed. The compliant member 112 may be configured to exert forcesagainst the upper and lower handle portions 108, 110, to bias them awayfrom one another, holding the handle portions in a naturally spacedapart position.

In this embodiment, the proximal end of the sheath 104 is attached tothe upper handle portion 108, while the lower handle portion 110 isattached to the proximal end of the elongate member 114. The elongatemember 114 may be a flexible member, disposed within the lumen of thesheath 104, extending proximally from the end-effector unit 106 to thelower handle portion 110. Structure of the elongate member 114 may be inthe form of a flexible shaft, coil, cable, or wire.

Attachment of the sheath 104 and the elongate member 114 to the upperand lower handle portions 108, 110 may be accomplished using a number ofdifferent permanent and temporary connection techniques. Examples ofpermanent techniques may include welding, soldering, gluing, or crimpingthe proximal end of the sheath 104 or the elongate member 114 withcontacting portions of the upper or the lower handle portion 108, 110.An example of temporary attachment may include screw-fit or snap-fitconnections. For example, the upper and lower handle portions 108, 110may include unthreaded or threaded annular protrusions or grooves (notshown) around which or into which the proximal end of the sheath 104 orthe elongate member 114 may be attached. It will be understood thatthese connection techniques may be utilized to attach these parts or anyother parts of the medical device in this embodiment or in otherembodiments, without departing from the scope of the present invention.For example, these techniques may be utilized to attach the sheath 104to the lower handle portion 110 and the elongate member 114 to the upperhandle portion 108 in other embodiments.

Although the depicted embodiment illustrates a single elongate member114, those of ordinary skill in the art will appreciate that anysuitable number of elongate members 114 may extend from the handle 102to the end-effector unit 106. Further, the diameter of the elongatemember 114 and the sheath 104 may be relatively smaller than thediameter of the upper handle portion 108 and the lower handle portion110. Depending on the application, the diameter of the sheath 104 andelongate member 114 may vary (e.g., smaller for narrower body cavities),however, the handle portions 108, 110 may have a relatively standardsize (depending on the palm size of the operator). For example, thehandle 102 may have a size that comfortably fits in the palm of anoperator.

Actuating the end-effector unit 106 between a collapsed state (FIG. 1)and an expanded state (FIG. 2) may be accomplished by pushing one handleportion (upper, lower) towards the other, or both towards each otheragainst the force applied by the compliant member 112. In the expandedstate, the end-effector unit 106 may retrieve an object from within thebody, or perform any desired function.

The handle 102 is gripped in the palm of an operator, and may includegeometric features, such as finger grooves in the upper handle portion108, to assist in handling the medical device 100. FIG. 3 illustratesone such embodiment in which the upper handle portion 108 includes fourseparate grooves 302 for a user's fingers. It will be understood thatFIG. 3 is merely exemplary and that other groove designs may also becontemplated. For example, the upper handle portion may include twogrooves (one on each side of the sheath). Each groove may thenaccommodate two fingers. Moreover, the lower handle portion may includea groove for the operator's thumb. Other geometries, such as rings forreceiving the operator's fingers may also be considered. With referenceto FIGS. 1-3, it will be understood that the upper handle portion 108and the lower handle portion 110 may be spaced apart at a distance thatallows an operator to hold both the handle portions in a single hand andbring the handle portions together with ease when actuating theend-effector unit 106.

In the medical device 100, the end-effector unit 106 advances out of thesheath 104 when the handle portions are brought together, and withdrawsinto the sheath 104 when the handle portions are spaced apart. Asalluded to above, the end effector unit 106 may be configured toself-expand when it is released from the constraints of the sheath 104.In addition, the end-effector unit 106 may be configured to return to acompressed state as it is being withdrawn into the sheath 104.

FIGS. 4, 5, and 6 illustrate another embodiment of the medical device400 in which the end-effector unit 106 is in the extended and expandedoperable state when the handle portions are spaced apart (FIG. 4) and inthe withdrawn and collapsed state when the handle portions are broughttogether (FIG. 5). FIG. 6 illustrates an exploded view of the medicaldevice of FIGS. 4 and 5. To achieve this configuration, the sheath 104may be attached to the lower handle portion 110, instead of the upperhandle portion 108, while the elongate member 114 may be connected tothe upper handle portion 108. It will be understood that in thisembodiment the first handle portion is embodied as the lower handleportion 110 (at the proximal end of the handle), while the second handleportion is embodied as the upper handle portion 108 (at the distal endof the handle).

The upper handle portion 108 may include a hollow ring 602 (shown inFIG. 6) through which sheath 104 may pass. The hollow ring 602 may havea thickness comparable to the thickness of the sheath 104 so that thesheath 104 passes through the upper handle portion 108 with relativeease and without excessive friction. The upper handle portion 108 mayfurther include a solid central portion 604 where the elongate member114 is attached. FIG. 6 is an isometric view of the medical deviceclearly depicting the hollow ring 602 and the central portion 604. Thehollow ring 602 allows unrestricted motion between the sheath and theupper handle portion 108.

When the upper handle portion 108 is brought towards the lower handleportion 110 against the force of the compliant member, the elongatemember 114 may be pulled proximally into the lumen of the sheath 104,thereby collapsing and retracting the end-effector unit 106 into thesheath 104. Alternatively, when the lower handle portion 110 is pushedtowards the upper handle portion 108, the sheath 104 may extenddistally, covering the exposed end-effector unit 106, thereby collapsingit.

In the embodiment described with reference to FIGS. 4-6, the compliantmember 112 may be present within the sheath 104 (preferably at theproximal end of the sheath. Here, the compliant member 112 may notinclude a lumen or be shaped as a sleeve. Instead, the complaint member112 may have any shape which is insertable into the sheath 104. Thelength and compressibility of the compliant member 112 may beconfigured, such that there is sufficient distance between the upperhandle portion 108 and the lower handle portion 110 in the spaced apartposition and such that compression of the handle portions substantiallycollapses and retracts the end-effector unit 106 into the sheath 104.

To lock the end-effector unit 106 in a particular state, such as anexpanded state in the first embodiment (FIG. 2) or a collapsed state inthe second embodiment (FIG. 5), the handle 102 may include a lockingmechanism. It will be understood that various locking mechanism may beused, as known in the art, without departing from the scope of thepresent disclosure. FIGS. 7-8 illustrate two such locking mechanisms.

FIGS. 7A and 7B illustrate a locking mechanism applicable to the firstembodiment of the medical device 100. It will be understood, however,that with minor modification in the design, this locking mechanism willbe suitable for the second embodiment of the medical device as well. Asillustrated, the lower handle portion 110 includes a depressible buttonor a push-button 702. Further, the sheath 104 within the upper handleportion 108 includes a groove 704 and the elongate member 114 (betweenthe two handle portions) includes a corresponding protrusion 706. Whenan operator brings the upper and lower handle portions 108 and 110together, and wishes to lock the handle 102 in this position, theoperator may push the depressible button 702 which extends theprotrusion 706 outward from the elongate member 114, engaging it in thegroove 704 and locking the handle 102 in that position. At this stage,the operator may release the force applied on the handle 102, allowingher to efficiently utilize the end-effector unit 106 to perform thedesired operation.

When the operator wishes to collapse the end-effector unit 108, she mayrelease the depressible button 702, which retracts the protrusion 706inwards, releasing the contact between the sheath 104 and the elongatemember 114. The handle portions may then return to their normallyspaced-apart position. FIG. 7A illustrates the handle 102 in the spacedapart position, while FIG. 7B shows the handle 102 in the lockedposition.

It will be understood that the number of protrusions and grooves mayvary without departing from the scope of the present disclosure.

FIGS. 8A, 8B, and 8C illustrate another embodiment of a samplemechanical locking mechanism. This mechanism includes a protrudingengaging member, such as a pin 802 on one handle portion (lower handleportion 110, for example), and a hook 804 on the other handle portion(upper handle portion 108, for example). The operator may bring thehandle portions 108, 110 together and then lock them in position byengaging the hook 804 with the pin 802 as illustrated in FIGS. 8B and8C. Both the locking mechanisms described with reference to FIGS. 7 and8 are known in the art, and therefore they are not explained in detailhere.

FIGS. 9A-9C illustrate another embodiment of the medical device 900. Theprevious embodiments of the medical device 900 included an end-effectorunit present within the lumen. This particular embodiment of the medicaldevice, however, presents a hollow sheath. This way, any tool oreffector unit may be inserted through the handle and guided towards thedistal end of the sheath without replacing the entire device.

The medical device 900 includes the handle 102 and the sheath 104. Thehandle 102 includes the upper handle portion 108, the lower handleportion 110, and a connecting portion, such as tube 902, between theupper and lower handle portions 108, 110. The proximal end of the sheath104 is attached to the upper handle portion 108 and the proximal end ofthe tube 902 is attached to the lower handle portion 110. The distal endof the tube 902 is not connected to any member, but is movably mountedwithin the upper handle portion 108 and the sheath 104. In anotherembodiment, the tube 902 may be movable relative to the lower handleportion 110, but fixed relative to the upper handle portion 108. Thediameter of the tube 902 is such that it may, slide within the sheath104 comfortably. Compliant member 112, such as a helical spring or anelastic sleeve may be disposed about the tube 902 to keep the upper andlower handle portions 108, 110 spaced apart. Application of a certainamount of force compresses the compliant member 112, pushing the tube902 through the upper handle portion 108, and bringing the lower handleportion 110 closer to the upper handle portion 108.

The upper handle portion 108 and the lower handle portion 110 mayinclude holes 904 and 906, respectively, along the longitudinal axis. Inone embodiment, tube 902 passes through hole 904 of the upper handleportion 108, but is attached within the hole 906 of the lower handleportion 110, thereby substantially aligning the holes 904 and 906longitudinally.

Any effector unit, tube, or other suitable medical device may beinserted in the medical device 900 through the hole 906. For example, asuction tube or a catheter may be guided through the handle 102 and thesheath 104 towards the operation site within a body. To accurately guidethe inserted medical device towards the distal end of the sheath 104,the handle 102 may include a guiding mechanism.

To describe the guiding mechanism, in FIGS. 9A, 9B, and 9C, theend-effector unit is illustrated as a suction tube 908. It will beunderstood, however, that any other effector unit may be inserted andguided using this mechanism, without departing from the scope of thepresent disclosure. The suction tube 908 may be initially guided throughthe sheath 104 manually. Once the suction tube 908 reaches near thedistal end of the sheath 104, however, accurate guiding and positioningmay be required. For this positioning, the handle 102 may includecertain engaging members, such as protrusions 910. It will be understoodthat the protrusions 910 may be barbs, annular protrusions, inflatablemembers or any other structure that can protrude into hole 906 to graspor otherwise frictionally secure the suction tube 908 without deformingor damaging the suction tube 908. Moreover, the shape of the protrusions910 may be conical, cylindrical, spherical, or any other such shapewithout departing from the scope of the disclosure. The function of theprotrusions 910 is to hold the suction tube 908, enabling it to movealong with the lower handle portion 110 when the lower handle portion110 is pushed towards the upper handle portion 108.

In one embodiment, these protrusions 910 extend out of the inner surfaceof tube 902 only when the handle portions are moved toward each other.So, when the operator pushes the lower handle portion 110 toward upperhandle portion 108, the protrusions 910 engage with the suction tube908, moving the suction tube 908 distally in relation with the sheath104. When the forces on the handle portions are removed, the protrusions910 retract, leaving the suction tube 908 in the newly moved position,while retracting the tube 902 to its initial position. In this manner,the operator can accurately position any effector device, such as asuction tube, a catheter, and so on, at the operation site.

In case of angiographies and angioplasties, for example, the operatormay first insert a catheter into an artery and then inject a dye to viewany blockages in the artery. Then, using the same medical device, theoperator may insert a stent into the blockages. To this end, the stentand the catheter may be supplied in the body through the medical device900.

The device of FIGS. 1-9 may access a surgical site through an auxiliaryaccess channel of an endoscope. The distal portion of the sheath 104 andthe end-effector unit 106 may be inserted through a medical viewinginstrument, such as a ureteroscope for viewing a surgical site duringurologic surgery. The sheath 104 and the end-effector unit 106 may bereceived within an access channel of an endoscope such that the distalend of the sheath 104 (and end-effector unit 106) extends beyond thedistal end of the endoscope. Therefore, actuation of the end-effectorunit 106 can be viewed through the endoscope during a treatmentprocedure. In some embodiments, medical device 100 may be configured forinsertion with the aid of a guidewire (not shown). For example, thesheath 104 may include a guidewire lumen (not shown) disposed on anouter surface thereof.

Upon insertion through an access channel of an endoscope, the medicaldevice 100 can be moved relative to the endoscope. The sheath 104 maycorrespond in length to the length of the ureteroscope such that thedistal ends of the two devices are substantially aligned during use.

Alternatively, the distal end of the sheath 104 may include one or morevisualization markers (not shown), such as visible and non-visiblemarkers; radiopaque markers; magnetic markers; ultrasonically reflectivemarkers; and combinations thereof. With the help of a fluoroscope,ultrascope, or an endoscope, the operator may ascertain the exactlocation of the distal end of the medical device. Moreover, the markershelp guide the medical device, through the body cavities, towards theoperation site. The marker may be in the form of one or more ringsaround the distal end of the sheath, or any other shape withoutdeparting from the scope of the present disclosure.

The sheath 104 may also be used to provide electrical connection forend-effector units that require power to operate. An electrical wireconnected to the end-effector unit may run along the length of theelongate member 114 or the sheath 104 and be connected to a batterymodule or an AC power connection provided in the lower handle portion110.

In another embodiment, the sheath 104 may include multiple elongatemembers 114 or end-effector units 106. During urological medicalprocedures, the end-effector unit 106 may be positioned to graspremovable material from a surgical treatment site. Often, materialgrasped, such as a kidney stone, is too large to be removed from thesite without breaking down the material first. A lithotriptor, which caninclude a laser fiber for directing energy to break down the material,may be concurrently introduced with the end-effector unit 106, which mayalso be used as a backstop during lithotripsy. The sheath 104 may alsobe used to introduce other medical devices such as ablation probes,lithotriptors, or cautery apparatus, so that these medical devices arealso actuated when the end-effector unit 106 is actuated. For example, alaser probe and graspers may be positioned inside the lumen of thesheath 104, each attached to different elongate members.

FIG. 10 illustrates an additional embodiment of the present disclosuredirected to a medical device handle 1002 for the relative movement ofmultiple end-effector units. The medical device 1000, as shown in FIG.10, houses multiple end-effectors, such as a grasping end-effector unit1004 for manipulating material within a patient's body and a device forbreaking up material, such as a lithotriptor 1006.

As seen in FIG. 10, the medical device 1000 includes the handle 1002 andtwo sheaths 1008 and 1012, each with parts similar to the sheath in FIG.1 (i.e., a lumen, a proximal end, and distal end). The lumen of thefirst sheath 1008 may include a basket 1004 attached to an elongatemember 1010, the proximal end of which is connected to the lower handleportion 110. The lumen of the second sheath 1012 may include alithotriptor 1006 attached to a second elongate member 1014, theproximal end of which is connected to the lower handle portion 110.

In one embodiment, by bringing the handle portions together, an operatormay simultaneously actuate both end-effector units. In some situations,however, the operator may not require both the medical devicessimultaneously. For these situations, the handle 1002 further includes amechanism for selectively actuating only one end effector. In oneembodiment, the handle 1002 may include a first button 1016 for thebasket 1004 and a second button 1018 for the lithotriptor 1006. Theelongate members 1010 and 1014 may be connected to a longitudinallymovable surface (not shown) of the lower handle portion 110. Thismovable surface may travel between two positions—one at the top of thelower handle portion 110 (the effector unit 1004 is in this position)and the second at the bottom of the lower handle portion 110 (effectorunit 1006 is in this position). The lower handle portion 110 below themovable surface may be substantially hollow, allowing the movablesurface to move between the first and second positions.

When the corresponding button (such as the first button 1016) isdepressed, the movable surface is placed in the first position, i.e., atthe top. Now, when the handle portions are brought together, only theselected end-effector unit will extend distally out of the sheath, whilethe other end-effector unit does not extend beyond the distal end of thesheath (as shown in FIG. 10B).

It will be understood that this selective mechanism is merely exemplaryand any other mechanism to selectively activate one end-effector may beutilized without departing from the scope of the present disclosure.Moreover, the number of end-effector units may not be restricted to onlytwo. More end-effectors may be connected to the handle 1002 as required.Further, the attached medical devices may be detachably connected, sothat the same handle may be utilized for one or more end-effectors, asrequired. For example, embodiments of the disclosed handle may bere-usable and therefore configured for repeated connection withdisposable end-effectors.

The medical devices 1004 and 1006 may be inserted into an auxiliaryaccess channel of a ureteroscope. Accordingly, handle 1002 allows formovement of both end-effector units 1004 and 1006 relative to theviewing area observed by the ureteroscope. In addition, movement of theupper and lower handle portions 108, 110 and the activation of the firstand second buttons 1016, 1018 allow relative movement between theend-effector units housed within the medical device 1000.

In the embodiments described here and in the numerous other embodiments,the sheath diameter may vary between 5 FR to 15 FR. Preferably, thesheath diameter may be approximately equal to 10 FR. Moreover, thesheath may be rigid enough to provide better control for the operator,but at the same time flexible enough to easily maneuver within thepatient's body.

Though shown with a retrieval device (and particularly a basket) and alithotriptor device, the handles described above can be used with anyother medical devices which require actuation or longitudinalpositioning of medical devices at a treatment site. The reference to theuse of a retrieval device and lithotriptor are used as examples and arenot intended to limit the scope of the present disclosure.

Embodiments of the present disclosure may be used in any medical ornon-medical procedure, including any medical procedure where removal ofan object from within a body lumen is desired. In addition, at leastcertain aspects of the aforementioned embodiments may be combined withother aspects of the embodiments, or removed, without departing from thescope of the present disclosure.

Other embodiments of the present disclosure will be apparent to thoseskilled in the art from consideration of the specification and practiceof the inventions disclosed herein. It is intended that thespecification and examples be considered as exemplary only, with a truescope and spirit of the disclosure being indicated by the followingclaims.

What is claimed is:
 1. A device comprising: a sheath including a distalend, a proximal end, and a first lumen and a second lumen extendingtherebetween; a first elongate member in the first lumen, the firstelongate member including a distal end with an end-effector unit and aproximal end; a second elongate member in the second lumen, the secondelongate member including a distal end that directs energy out of thesecond lumen; and a handle including a first handle portion connected tothe proximal end of the sheath and a second handle portion connected tothe proximal end of the first elongate member, the first and secondhandle portions being biased away from one another to contain theend-effector unit in the first lumen and moveable towards one another toextend the end-effector out of the first lumen.
 2. The device of claim1, wherein the end-effector expands when extended out of the firstlumen.
 3. The device of claim 2, wherein the end-effector isself-expandable.
 4. The device of claim 2, wherein the second elongatemember is a laser fiber, and the energy is a laser energy.
 5. The deviceof claim 4, wherein the end-effector provides a backstop for the laserenergy.
 6. The device of claim 1, wherein the first elongate member is asuction tube.
 7. The device of claim 1, wherein second elongate memberis one of an ablation probe, a lithotriptor, or a cautery apparatus. 8.The device of claim 1, further comprising a mechanism on the handleoperable to selectively direct the energy.
 9. The device of claim 8,wherein the end effector is a grasping device and the second elongatemember is a laser probe.
 10. A system comprising: a scope including adistal end and at least one channel; and a device including: sheathincluding a distal end, a proximal end, and a first lumen and a secondlumen extending therebetween; a first elongate member in the firstlumen, the first elongate member including a distal end with anend-effector unit and a proximal end; a second elongate member in thesecond lumen, the second elongate member including a distal end thatdirects energy out of the second lumen; and a handle including a firsthandle portion connected to the proximal end of the sheath and a secondhandle portion connected to the proximal end of the first elongatemember, the first and second handle portions being biased away from oneanother to contain the end-effector unit in the first lumen and moveabletowards one another to extend the end-effector out of the first lumen,wherein a distal portion of the sheath is receivable in the at least onechannel to place the distal end of the sheath at the distal end of thescope.
 11. The system of claim 10, wherein the end-effector expands whenextended out of the first lumen.
 12. The system of claim 11, wherein thesecond elongate member is a laser fiber, and the energy is a laserenergy.
 13. The system of claim 10, wherein the distal end of the sheathis extendable beyond the distal end of the scope.
 14. The system ofclaim 10, wherein the scope includes an imaging device and theend-effector is viewable with the imaging device when extended out ofthe first lumen.
 15. The system of claim 10, wherein a length of thesheath is approximately equal to a length of the at least one channel.16. A method comprising: placing a distal end of a device at a treatmentsite, the device including a sheath including a proximal end opposite ofthe distal end, a first lumen and a second lumen extending therebetween,and a first elongate member disposed in the first lumen, the firstelongate member including an end-effector; grasping a handle of thedevice, the handle including a first handle portion connected to aproximal end of the sheath and a second handle portion connected to aproximal end of the first elongate member, the first and second handleportions being biased away from one another; moving the first handleportion towards the second handle portion to extend the end-effector outof the first lumen; and directing energy out of the second lumen. 17.The method of claim 16, wherein the device includes a mechanism on thehandle for selectively directing the energy, and the directing stepfurther comprises operating the mechanism.
 18. The method of claim 16,further comprising placing a distal end of a scope at the treatmentsite, the scope including at least one channel, wherein the distal endof the device is placed at the treatment site when inserted into the atleast one channel.
 19. The method of claim 18, further comprisingpositioning the distal end of the device at or beyond a distal end ofthe at least one channel of the scope.
 20. The method of claim 19,wherein the scope includes an imaging device, and the method furthercomprises viewing the end-effector with the imaging device beforedirecting the energy.